Will America's Mental Health System Change?

January 18, 2013

With all the recent talk about gun control and mental health, I decided to take a look at how far America’s mental health system has changed (or not changed) over the past few years.

First, I must state that when I wrote a blog about Mental Illness and the Law, the research shows that those with mental illness are no more violent than the general population when substance abuse is not involved.  In fact, according to an overview published in the June 2003 issue of World Psychiatry, one of the findings was:

“Substance abuse appears to be a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not. Those with substance disorders are major contributors to community violence, perhaps accounting for as much as a third of self-reported violent acts, and seven out of every 10 crimes of violence among mentally disordered offenders.”

In my opinion, if substance abuse is not addressed in the effort to decrease gun violence and improve the mental health system, there may be minimal changes.  So that being said, I will now ponder the question, “Will America’s mental health system change?”

I do believe the proposed changes to the mental health system addressed in the recent executive orders on guns, can help bring about positive changes to America’s mental health system.  But, why does it always take tragedy for changes to occur?

The mental health system in America has been broken for years.  In fact, the National Alliance on Mental Illness (NAMI), reported back in 2009 that America’s overall grade for the mental health system was a “D”, this is one grade away from failure.  The report graded every state.  Zero states received an “A”, six states received a “B”, eighteen states received a “C”, twenty-one states received a “D” and six states received a failing grade of “F.”

The report compared the 2009 report scores to the 2006 scores and there was no overall improvement.  In fact, the majority of states had no improvement and some even scored a lower grade.  The 2006 overall grade was a “D.”  The same overall grade received in 2009.  So basically, after three years, there was no improvement in America’s mental health system.

So I ask again, why does it always take tragedy for necessary changes to be addressed?  I wish I could answer this question.  It makes no sense to me.  As far as my original question, “Will America’s mental health system change?”  I tend to be an optimist so my answer is “yes.”  As to when, where and how, I do not know.  I can only hope changes will occur sooner rather than later.  I hope that all of the states will improve and that changes will occur proactively rather than re-actively.

I would appreciate hearing what others believe is the answer to the question, “Will America’s mental health system change?.  Change often starts one person at a time so when more individuals come together, the greater the chance that change will happen.


Grading the States 2009


Grading the States 2006


Executive orders on guns address mental health changes


Violence and Mental Illness: an overview